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The sheriff added that “no cogent explanation was provided” how the high risk presented by the taps in a custom designed building for the care and protection of vulnerable young people “came to exist and thereafter persist”.

He said: “It’s plain that an incident such as that which lead to and ended in this tragic death, was foreseeable.

“The failings in these case persisted over a lengthy period of time, in my judgement these failings were plainly serious.”

The court heard Skye House deals with young people with a wide range of mental health issues.

Glasgow Sheriff Court heard Louise was admitted twice - the second time in August 2013.

There had been reports of Louise self-harming - checks were then carried out on the teenager every 15-minutes.

On September 2013, she was said to have had a "settled day".

A nurse then carried out routine checks that night.

Louise was initially in her bed, but then found to be in her en suite bathroom.

The nurse later knocked on the door - but there was no response.

Staff rushed to help - including carrying out CPR - before Louise was taken to the city's Royal Infirmary.

She did not survive having failed to regain consciousness.

An investigation was then carried out.

The court heard one staff member claimed: “We were told everything was anti-ligature.

"We didn’t really think about the taps.”

The hearing was told all taps in patients' bathroom have now been replaced.

The board's QC Peter Gray said “robust steps have been taken to address the failing”.

He also wished to pass on condolences for what happened.

Last year, the health board were fined £100,000 after two patients committed suicide in two different hospitals.

Mum-of-two Louise Docherty, 27, died at Dykebar Hospital in Paisley in 2014 after being found unconscious in a hospital toilet.

Her death followed that of 44-year-old Kenneth McRae at Stobhill Hospital in 2012. Both patients had been assessed as high risk.

NHS Greater Glasgow and Clyde admitted health and safety failings at the same court and acknowledged that it had failed to carry out proper observations, leading to the two deaths.